18.
DDT and DDE commentary – Possible explanations for lack of an association

Chemical formulation

In white western women, predominate exposure may not be to estrogenic o,p’-DDT found in the insecticide, but to the very weakly estrogenic, anti-androgenic breakdown product, p,p’-DDE found as residues in food

Heavily exposed populations not well studied

Predominate use of DDT in the US was on cotton in the south-eastern. One study of African Americans women from North Carolina suggests positive association of DDE and breast cancer risk

Few studies of breast cancer risk in countries that currently use DDT for malaria control

Critical windows of exposure need evaluation

Little information on whether exposure to DDT during early breast development affects breast cancer risk